Attorney Laura Cavaretta, second from
left, talked about handling patients at UMC during a press conference Friday in the medical center's board room. Dr. Jose Burgos is at left, UMC Board Chair Tracy Yellen is next to Cavaretta and Blas Meza, emergency medicine director, is at right.

The recent lawsuit filed against the University Medical Center of El Paso and U.S. Customs and Border Protection for allegedly performing a cavity search on a woman without her consent or a search warrant has prompted major changes in the hospital's policies and procedures.

Some of the changes to be put in place or already implemented as recommended by a recent review include updating policies, improving communication with law enforcement, continuing medical staff training to educate patients about their rights, and improvements in the hospital's Electronic Medical Record system.

REPORTER

Aileen B. Flores

Hospital officials emphasized that if a patient does not consent to a body search, one will not be performed until a court order is obtained by the law-enforcement agency seeking it. Also, officials said the hospital's main objective is to provide health care and not enforce criminal laws.

In December, the American Civil Liberties Union filed a suit against the county hospital on behalf of the woman identified as Jane Doe. The suit claims the New Mexico woman, who was returning to the U.S. from Juárez through one of the international bridges in El Paso, was taken to the hospital and subjected to an inhumane search on Dec. 8, 2012.

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The woman claims two officers with U.S. Customs and Border Protection subjected her to a six-hour body cavity search that included extensive frisking, an observed bowel movement, and X-rays, speculum and vaginal exams, and a CT scan at the hospital.

The suit claims the hospital "violated her" and then gave her the $5,000 bill. No drugs were found. UMC officials have declined to talk about the Jane Doe case because the lawsuit is pending.

The UMC Board of Managers in January — when they learned about the lawsuit — authorized hospital CEO Jim Valenti to find an outside firm to conduct an independent review of the hospital's policies, procedures, and practices related to patients brought to the hospital by law enforcement.

UMC then hired Cavaretta, Katona, and Francis, PLLC to perform the study. The study was given to the board on Monday and was released to the public on Friday at a news conference.

San Antonio Lawyer Laura Cavaretta, the author of the report who attended a news conference, said she studied state and federal laws, interviewed UMC staff, reviewed policies, procedures and practices at UMC and looked at what other hospitals in Texas do for her review.

The analysis shows that UMC practices comply with the law, but the hospital needs to emphasize patients' rights and education, as well as better communication with law enforcement, she said.

Cavaretta made five recommendations:

•Continue to acknowledge that physicians are the ones who make decisions on patient care.

•To streamline policies and procedures related to patient consent and warrant requirements, including an emphasis that health providers are patient advocates and that any patient brought to the hospital by law enforcement for a body search is not responsible for payment.

•Formalize and execute on-going training for hospital staff to educate patients about their rights while being treated.

•Evaluate changes to the Electronic Medical Record system to file patient consent forms electronically.

The UMC Board of Manages on Monday voted unanimously to adopt and implement all five recommendations immediately, said Tracy Yellen, Chair of the UMC Board of Managers.

Margaret Althoff-Olivas, a spokeswoman for the UMC, said the hospital is in the process of making the policies more clear and accessible to patients and medical staff. She said numerous policies are being consolidated.

For example, policies on information consent, general patient consent and patients in custody of law enforcement are being combine into one policy so that "all patients are treated the same" regardless their reason for being in the hospital, Aulthoff-Olivas said.

Blaz Mesa, director of the UMC Emergency Department, said the hospital is in the process of educating staff to educate patients about their rights. One of the initiatives Mesa mentioned is the expansion of the "speak up campaign," which encourages patients to ask questions about their care.

Patients taken into the hospital by law enforcement for a cavity search have the right to say no with the understanding that their life may be in danger, Althoff-Olivas said.

If the patient does not give consent to be searched, then law enforcement is required to present a court order to proceed with the search or "medical assessment", said Dr. Jose Burgos, director of UMC's Hospitalist Program.

Burgos said only "a handful" of patients are treated for "body packing" every year at the hospital. Body packing is when somebody hides an illegal substance or drug inside a body cavity, Burgos explained. "Body packing is a medical emergency because it's a potential life-threatening condition," he said.

One of the report's main findings was lack of communication between the hospital and law enforcement agencies to clarify that the hospital's mission is not to enforce the law, but to provide health care.

"There has been no attempt to engage in a dialogue with law enforcement about the fact that UMC-El Paso is a health care provider and not an arm of law enforcement," the report says.

Althoff-Olivas said UMC would like every law enforcement agency that takes patients into the hospital to have a liaison who understands the hospital policies and procedures.

The review also indicates that there has not been any dialogue with law enforcement agencies about billing practices when people are taken to the hospital "for law enforcement purposes."

In the Jane Doe lawsuit, Althoff-Olivas said it was similar to when the hospital bills an insurance company and it denies the claim. She said CBP was billed and it denied paying it. Then the woman received the bill because CBP refused to pay it.

In addition, the report found flaws in the Electronic Medical Record system. "The ERM is not fully operational such that documents such as the General Consent Forms are not scanned into the EMR and are subject to being misplaced, lost or never completed," the report states.

Althoff-Olivas said the hospital system does not recognize when a patient is taken to the hospital by law enforcement.

Althoff-Olivas said this is one of the changes that is going to take more time because it's expensive to update the system. In the meantime, the hospital is taking other measures in place to prevent problems.

"I believe that we are taking the appropriate steps to ensure that allegations such as those contained in the Jane Doe lawsuit never surface again," Valenti said in a statement.

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